New doors in healthcare research are opening thanks to a multi-faceted partnership focused in Reno.

The innovative population health study that began in September combines clinical data from Renown Health, environmental data from Desert Research Institute (DRI), genetics from 23andMe, plus support from the State of Nevada.

The study could have far-reaching impacts beyond the research lab, into community healthcare and the healthcare industry itself in northern Nevada.

"This data set is a tremendous resource to tap into," Anthony Slonim. M.D., president and CEO of Renown Health, told the NNBW during a conference call that included Joseph Grzymski, DRI senior director and research professor.

"The uniqueness is derived from combining clinical, environmental, social and genetic data into one database that can be queried," Slonim explained.

The goal is to improve health outcomes. To not just treat disease, but prevent disease by finding connections in the three types of data.

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The research could uncover disease triggers, which could then open doors for therapies to begin years before the disease manifests.

The study is also expected to create new economic benefits in the region.

"One of our weaknesses is in biotechnologies and healthcare sectors," Slonim said. The study "shines a light on Nevada for doing cutting-edge research."

That can only enhance recruitment of top scientists and doctors to the region.

"They look for intellectual stimulation as well as quality of life. This is one more aspect for recruitment," he said.

Pinpointing genotype signatures of disease can also open opportunities for new drugs and treatments, Slonim said.

The Beginning

More than a year ago, Renown Health and DRI established a two-way research partnership, Grzymski explained.

The goal was to combine DRI's environmental data with Renown's clinical data to look for health links.

In June 2016 they attended the BIO International Convention in San Francisco. The largest biotech convention in the world, it brings together representatives from major biotech and healthcare firms, nonprofits, and government officials. According to the conference website, nearly 16,000 industry leaders from 76 countries attended the four-day conference in 2016 with 1,800 exhibitors and more than 800 speakers.

The annual conference also provides meeting opportunities to foster partnerships. It was here that Renown and DRI connected with 23andMe.

"We were just launching a research platform," Ruby Gadelrab, vice president, commercial marketing for 23andMe, told the NNBW during a conference call that also included Andy Kill, media relations with 23andMe.

"It just came at a good time to help others with their research."

Based in Mountain View, Calif., 23andMe is a direct-to-consumer genetics company, but also wants to see the genetic information they gather used to benefit research and contribute to healthier communities.

"What's less well known, is that we have an entire team dedicated to gene research," Kill said.

Sixty PhDs on staff at 23andMe collaborate with a number of universities and institutions. They've produced 60 peer review studies, he said.

At the BIO conference, the Nevada population study grabbed the attention of the 23andMe team.

The Reno region has "multiple generations of the same families in the area that is well documented," Gadelrab said, "and DRI had a lot of environmental data."

Adding the genetic component makes the Nevada study unique, she said.

The Reno team liked the 23andMe concept of giving personal genetic data back to research volunteers.

"We put together a deal with (23andMe) in lightning speed," Grzymski said, comparing it to the slower pace of research-industry standards.

Recruiting

Recruitment of study volunteers also happened at lightning speed.

On Sept. 15 at the DRI campus in Reno, Gov. Brian Sandoval announced the partnership and study, and that he had been the first volunteer to give a DNA sample for the Nevada population study.

The recruitment of 5,000 volunteers that began that day was expected to take days, if not weeks.

Within a few hours, all 5,000 DNA sample kits were spoken for and 5,000 more authorized. All 10,000 were claimed within 48 hours.

"I've been in genetics more than 20 years, and the most amazing thing (in the Nevada study) was recruiting," Gadelrab said.

It's not unusual for recruitment to fall far short of researchers' goals.

The researchers are now looking to add to their pool of DNA donors with more targeted sampling.

"In the first part of the project, we did 'convenience' sampling — volunteers who agree to participate," Grzymski said. "The next little bit is more direct (to get genetic information about what) we really want to understand about cancer, neurological disease, Alzheimer's. That requires 'purposive' (sampling from specific people with a disease or a family history of the disease)."

Researchers hope to gather purposive sampling from 3,000 to 5,000 volunteers in each of several categories including with cancer, with Alzheimer's disease and from rural environments

Research

"We just received (from 23andMe) all genotype data from the 10,000 people who participated," Grzymski said. "We are going back to those participants and asking specific questions like family history to associate a specific (genetic marker) to health risk, to establish a framework for purposive sampling."

Nevada's data will be compared to other demographic pools, or "cohorts."

"Is there something we see in Nevada that we don't see in other cohorts?" Grzymski asked.

Gadelrab, who talks to DRI once or twice a week, is curious about other result.

"Do people change behavior when they get results" that indicate susceptibility to cancer or cardiovascular disease?

"It would be amazing if our product helped people be healthier," she said.

Global interest

The amazing speed in which 10,000 volunteers joined the research project has researchers around the world a buzz.

DRI was a guest speaker at the American Society of human Genetics in October.

Slonim said calls come in weekly from researchers asking about the study.

"It does put northern Nevada on the map like it's never been before," he said.

Slonim and Grzymski have been invited to speak about the project in June at the 2017 BIO International Convention in San Diego. The convention that in 2016 they paid $10,000 to attend will not cost anything this year.

Grzymski expects to announce early results from the Nevada project, as Slonim talks to CEOs from major biotechnology companies about the potential benefits of Nevada's research model.

"This has never been done before around the world," he said of the Nevada population study.

"It started right here in Reno, Nevada. It started with an ambition just trying to drive the health conversation."